From the Department of Psychiatry, Samitivej Srinakarin Hospital, Bangkok, Thailand.
Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, Augusta, GA.
J ECT. 2019 Sep;35(3):153-155. doi: 10.1097/YCT.0000000000000584.
This commentary reflects upon the study of Braga et al of open-label continuation electroconvulsive therapy (ECT) plus clozapine in treatment-resistant schizophrenia (TRS), as reported in this issue of The Journal of ECT. The evidence base for ECT in TRS is scant, and the study of Braga et al is a step forward. However, their report raises other important questions including (1) what is the proper frequency of continuation ECT in TRS, and (2) should TRS patients, even TRS patients who have failed clozapine, receive acute ECT + clozapine, or is ECT + conventional antipsychotics sufficient? In this commentary, we examine these questions and outline a future research strategy for TRS that includes large simple trials.
这篇评论反思了 Braga 等人在治疗抵抗性精神分裂症（TRS）中进行的开放性继续电抽搐治疗（ECT）加氯氮平的研究，该研究发表在本期《ECT 杂志》上。ECT 在 TRS 中的证据基础很少，Braga 等人的研究是向前迈进的一步。然而，他们的报告提出了其他一些重要问题，包括（1）TRS 中继续 ECT 的适当频率是多少，以及（2）TRS 患者，甚至是氯氮平治疗失败的 TRS 患者，是否应该接受急性 ECT+氯氮平，还是 ECT+常规抗精神病药物就足够了？在这篇评论中，我们探讨了这些问题，并为 TRS 制定了一个未来的研究策略，包括大型简单试验。
